A patient developed signs of central nervous system (CNS) toxicity during treatment of postthoracotomy pain with a continuous intrapleural bupivacaine infusion. This incident occurred after the patient's chest tube was clamped, without any decrease in the bupivacaine infusion rate. This is the first reported case of CNS toxicity in a patient receiving a continuous intrapleural bupivacaine infusion. Possible etiologies of this complication are discussed, as are ways to avoid such a complication in the future.
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http://dx.doi.org/10.1016/s0952-8180(96)00176-6 | DOI Listing |
Cancer Immunol Res
November 2024
University Hospital of Lausanne, Lausanne, VD, Switzerland.
Pleural mesothelioma (PM) is a fatal disease with limited treatment options. Recently, PM management has improved with the development of immune checkpoint inhibitors (ICIs). In first-line therapy, dual PD-1 and CTLA-4 blockade enhances tumor control and patient survival compared with chemotherapy.
View Article and Find Full Text PDFJ Neurol Surg A Cent Eur Neurosurg
November 2024
Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fujieda city, Japan.
Background: Subarachnoid-pleural fistula is an abnormal communication between the subarachnoid and pleural spaces that can arise from blunt or penetrating trauma or as a complication of spinal surgery via the transthoracic approach. Uncontrolled cerebrospinal fluid (CSF) leakage with a fistulous condition after transthoracic spinal surgery could be more problematic than that after spinal surgery via the conventional posterior approach because of the negative pressure in the pleural cavity.
Case Description: The authors reported subarachnoid-pleural fistula management using chest and lumbar spinal drainage in five patients with several troublesome complications, such as intracranial subdural hematoma or severe respiratory dysfunction.
BMC Geriatr
November 2024
Cancer Prevention and Treatment Institute of Chengdu, Department of Oncology, The Second Clinical Medical College, Chengdu Fifth People's Hospital, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
Front Cell Infect Microbiol
November 2024
National Institutes of Health, National Cancer Institute, Thoracic Surgery Branch, Bethesda, MD, United States.
We present a patient with a post-pneumonectomy empyema refractory to surgical debridement and systemic antibiotics. The patient initially presented with a bronchopleural fistula and pneumothorax secondary to tuberculosis (TB) destroyed lung, which required a pneumonectomy with Eloesser flap. Ongoing pleural infection delayed the closure of the Eloesser flap, and thoracoscopic inspection of his chest cavity revealed a green, mucous biofilm-like structure lining the postpneumonectomy pleural cavity.
View Article and Find Full Text PDFJ Heart Lung Transplant
October 2024
Latner Thoracic Research Laboratories, Toronto Lung Transplant Program, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. Electronic address:
Background: Recent clinical series on donation after uncontrolled cardiovascular death (uDCD) reported successful transplantation of lungs preserved by pulmonary inflation up to 3 hours postmortem. This study aims to investigate the additive effects of in situ lowering of intrathoracic temperature and sevoflurane preconditioning on lung grafts in a porcine uDCD model.
Methods: After uDCD induction, donor pigs were allocated to one of the following groups: control-static lung inflation only (SLI); TC - SLI + continuous intrapleural topical cooling (TC); or TC+Sevo - SLI + TC + sevoflurane.
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